1 00:00:00,080 --> 00:00:02,480 This is Rosie Talaga with the Becker's Healthcare 2 00:00:02,480 --> 00:00:02,980 podcast. 3 00:00:03,359 --> 00:00:05,519 Today, I'm thrilled to be joined by Bruce 4 00:00:05,519 --> 00:00:09,220 Feldman, administrator of Eastern Orange Ambulatory Surgery Center, 5 00:00:09,279 --> 00:00:10,800 to talk about some of the biggest trends 6 00:00:10,800 --> 00:00:12,179 in the ASC industry. 7 00:00:12,639 --> 00:00:14,400 Bruce, it's a pleasure to have you on 8 00:00:14,400 --> 00:00:16,155 the podcast today. Thank you very much. Pleasure 9 00:00:16,155 --> 00:00:17,835 to be here. Can you please take a 10 00:00:17,835 --> 00:00:19,835 moment to introduce yourself and your work in 11 00:00:19,835 --> 00:00:20,414 the industry? 12 00:00:20,875 --> 00:00:22,894 Sure. My name is Bruce Feldman. 13 00:00:23,434 --> 00:00:25,675 I am in the ASC administrator for Easton 14 00:00:25,675 --> 00:00:29,054 Auditorium Military Surgery Center. We're a 4 operating 15 00:00:29,114 --> 00:00:31,134 room, 2 endoscopy suite, 16 00:00:31,829 --> 00:00:35,270 freestanding ASC located in Cornwall, New York. I've 17 00:00:35,270 --> 00:00:37,270 been in the ASC industry now for about 18 00:00:37,270 --> 00:00:37,770 30 19 00:00:38,229 --> 00:00:40,950 years, running a number of freestanding ambulatory surgery 20 00:00:40,950 --> 00:00:43,590 centers as well as ASCs that are joint 21 00:00:43,590 --> 00:00:44,090 ventures 22 00:00:44,625 --> 00:00:47,504 with large academic hospital centers predominantly in the 23 00:00:47,504 --> 00:00:49,445 New York and New Jersey area. 24 00:00:49,905 --> 00:00:52,304 Great. Thank you so much. Sure. So our 25 00:00:52,304 --> 00:00:56,004 first question surrounds the prediction that ASC volume 26 00:00:56,225 --> 00:00:58,784 across the country is expected to increase by 27 00:00:58,784 --> 00:00:59,284 16% 28 00:01:00,100 --> 00:01:00,840 by 2032. 29 00:01:01,780 --> 00:01:03,780 With this growth, what are the most pressing 30 00:01:03,780 --> 00:01:06,519 challenges to maintaining a positive patient experience? 31 00:01:06,979 --> 00:01:08,180 Well, I think the most, 32 00:01:08,739 --> 00:01:10,500 challenge is gonna really going to be to 33 00:01:10,500 --> 00:01:11,239 keep up 34 00:01:11,619 --> 00:01:13,400 with the acuity level 35 00:01:13,715 --> 00:01:14,534 of these cases. 36 00:01:14,995 --> 00:01:16,515 More and more of these cases that are 37 00:01:16,515 --> 00:01:18,135 shifting from a hospital setting 38 00:01:18,594 --> 00:01:20,295 are of a higher level acuity. 39 00:01:21,075 --> 00:01:24,534 And, not always ASCs have, you know, appropriate, 40 00:01:25,555 --> 00:01:26,055 staff 41 00:01:26,674 --> 00:01:27,734 that have the educational 42 00:01:28,034 --> 00:01:30,040 training to deal with some of these more 43 00:01:30,040 --> 00:01:31,019 complex cases. 44 00:01:31,400 --> 00:01:33,719 You know, ASCs many years ago were basically 45 00:01:33,719 --> 00:01:36,859 mostly very simple straightforward cases, you know, ophthalmology, 46 00:01:37,640 --> 00:01:38,140 GI. 47 00:01:38,599 --> 00:01:41,340 Now we're getting into complex cardiac cases, 48 00:01:42,274 --> 00:01:43,894 complex orthopedic cases. 49 00:01:44,354 --> 00:01:44,754 So, 50 00:01:45,155 --> 00:01:47,394 I think the biggest, challenge is really to 51 00:01:47,394 --> 00:01:49,715 make sure that you have the your staff 52 00:01:49,715 --> 00:01:51,174 have the educational training 53 00:01:51,554 --> 00:01:53,795 to be able to meet the, the clinical 54 00:01:53,795 --> 00:01:55,655 needs of the patients. Mhmm. 55 00:01:55,960 --> 00:01:58,520 And when you talk about the the staff 56 00:01:58,520 --> 00:02:00,140 training for complex cases 57 00:02:00,600 --> 00:02:03,020 and keeping up with the high acuity cases, 58 00:02:04,200 --> 00:02:06,840 what strategies have worked for your organization to 59 00:02:06,840 --> 00:02:07,980 tackle these challenges? 60 00:02:08,395 --> 00:02:09,754 Well, I think we've done a lot of 61 00:02:09,754 --> 00:02:11,675 partnering with some of the vendors like Smith 62 00:02:11,675 --> 00:02:12,974 and Nephew and Stryker. 63 00:02:13,754 --> 00:02:15,514 You know, they provide people to come in 64 00:02:15,514 --> 00:02:16,014 house, 65 00:02:16,474 --> 00:02:19,375 and do in service educational sessions and training. 66 00:02:20,474 --> 00:02:22,094 That has helped a great deal. 67 00:02:22,629 --> 00:02:24,150 I think you have to really get all 68 00:02:24,150 --> 00:02:26,389 your physicians involved as well when you're bringing 69 00:02:26,389 --> 00:02:28,629 in a new clinical service line to make 70 00:02:28,629 --> 00:02:31,030 sure that, you know, your staffing has the 71 00:02:31,030 --> 00:02:32,810 appropriate educational knowledge. 72 00:02:33,269 --> 00:02:35,430 So it's really a partnership between your vendors, 73 00:02:35,430 --> 00:02:36,169 your doctors, 74 00:02:36,805 --> 00:02:38,645 and making sure that everybody is kind of 75 00:02:38,645 --> 00:02:40,905 on board with what you're trying to accomplish. 76 00:02:41,284 --> 00:02:42,025 Got it. 77 00:02:43,605 --> 00:02:44,105 So 78 00:02:44,564 --> 00:02:46,344 thank you so much for sharing those strategies. 79 00:02:46,405 --> 00:02:48,245 Sure. And I'd also like to hear your 80 00:02:48,245 --> 00:02:50,645 thoughts on another prevalent issue which is the 81 00:02:50,645 --> 00:02:51,539 cost of care. 82 00:02:52,019 --> 00:02:54,500 So how do you think leaders can ensure 83 00:02:54,500 --> 00:02:57,060 that their staff are well equipped to help 84 00:02:57,060 --> 00:02:59,859 patients navigate the financial aspects of their care? 85 00:02:59,859 --> 00:03:02,500 Well, that that's where the difficulty lies, you 86 00:03:02,500 --> 00:03:03,719 know, lies because 87 00:03:04,334 --> 00:03:06,735 as these higher acuity cases shift from the 88 00:03:06,735 --> 00:03:08,514 hospital into the ASC environment, 89 00:03:08,974 --> 00:03:09,474 reimbursement 90 00:03:09,854 --> 00:03:11,474 has not met up with that. 91 00:03:12,014 --> 00:03:14,754 So it's very difficult to provide, you know, 92 00:03:14,974 --> 00:03:17,715 high quality of care at a higher cost, 93 00:03:18,780 --> 00:03:20,860 when your staff are not necessarily used to 94 00:03:20,860 --> 00:03:23,039 being so cost conscious, so to speak. 95 00:03:23,900 --> 00:03:25,659 So I think, again, it comes back to 96 00:03:25,659 --> 00:03:27,039 making your staff aware 97 00:03:27,580 --> 00:03:29,120 that a lot of these cases 98 00:03:29,900 --> 00:03:32,300 are higher acuity level, but we still have 99 00:03:32,300 --> 00:03:33,659 our costs that we have to keep in 100 00:03:33,659 --> 00:03:34,034 mind. 101 00:03:34,594 --> 00:03:35,794 So we one of the things we do 102 00:03:35,794 --> 00:03:37,974 like orthopedics is we develop PACS 103 00:03:38,275 --> 00:03:40,275 for certain procedures. So you're not opening up 104 00:03:40,275 --> 00:03:41,415 an entire tray 105 00:03:41,794 --> 00:03:43,335 and going through a ton of instruments. 106 00:03:43,635 --> 00:03:46,135 You have set instruments specific for that procedure. 107 00:03:46,580 --> 00:03:48,580 So that's a strategy that we've used, and 108 00:03:48,580 --> 00:03:50,439 I know other centers have used 109 00:03:50,739 --> 00:03:52,280 to keep your costs down, 110 00:03:53,860 --> 00:03:56,419 and, you know, maintain, the same quality of, 111 00:03:56,579 --> 00:03:58,754 of care. Got it. In these packs, how 112 00:03:58,754 --> 00:04:01,314 do you see that benefiting the patient to 113 00:04:01,314 --> 00:04:02,375 provide a relationship? 114 00:04:03,394 --> 00:04:05,634 Well, I I think it's better because you're 115 00:04:05,634 --> 00:04:06,754 not you're not wasting, 116 00:04:07,155 --> 00:04:08,294 supplies and equipment. 117 00:04:08,754 --> 00:04:11,634 The patients are getting, their procedures done in 118 00:04:11,634 --> 00:04:12,935 a quicker period of time, 119 00:04:13,520 --> 00:04:14,740 because it can be faster. 120 00:04:15,520 --> 00:04:17,040 You know, staff don't have to go out 121 00:04:17,040 --> 00:04:18,800 of the room to look for instrumentation because 122 00:04:18,800 --> 00:04:20,879 it's not in the tray. So everything just 123 00:04:20,879 --> 00:04:22,100 moves along more efficiently. 124 00:04:22,480 --> 00:04:24,560 Mhmm. The pay the patient gets done with 125 00:04:24,560 --> 00:04:25,699 their procedure quicker, 126 00:04:26,084 --> 00:04:28,185 quicker recovery time, and they're home. 127 00:04:28,644 --> 00:04:29,144 Great. 128 00:04:29,845 --> 00:04:31,464 Lastly, are there any additional 129 00:04:31,764 --> 00:04:34,805 challenges, innovations, or anything else on top of 130 00:04:34,805 --> 00:04:36,644 your mind for the industry that you'd like 131 00:04:36,644 --> 00:04:38,165 to talk about? Well, I think one of 132 00:04:38,165 --> 00:04:40,745 the biggest challenges is obviously the anesthesia shortage. 133 00:04:41,279 --> 00:04:43,600 And, I've attended some sessions here earlier, and 134 00:04:43,600 --> 00:04:45,300 everybody has the same concerns. 135 00:04:46,080 --> 00:04:48,740 You know, we're trying to develop innovative strategies 136 00:04:48,800 --> 00:04:50,500 with our anesthesia providers 137 00:04:50,960 --> 00:04:52,399 to see how we can benefit on both 138 00:04:52,399 --> 00:04:54,000 sides of the equation. So that that's, I 139 00:04:54,000 --> 00:04:55,699 think, is gonna be the greatest challenge 140 00:04:56,224 --> 00:04:58,464 for ASCs moving forward is how do we 141 00:04:58,464 --> 00:05:00,324 handle this huge shortage 142 00:05:00,625 --> 00:05:01,444 of anesthesiologists, 143 00:05:02,785 --> 00:05:04,884 and how can we continue to provide 144 00:05:05,345 --> 00:05:08,004 appropriate anesthesia services to our patients 145 00:05:08,544 --> 00:05:09,284 when reimbursement 146 00:05:09,584 --> 00:05:11,125 all around continues to decline. 147 00:05:11,509 --> 00:05:12,009 Absolutely. 148 00:05:12,629 --> 00:05:14,310 Well, thank you so much for joining us 149 00:05:14,310 --> 00:05:16,970 today and for speaking at Becker's 30th annual 150 00:05:17,110 --> 00:05:19,509 ASC meeting. It's been a pleasure. Sure. And 151 00:05:19,509 --> 00:05:21,110 I look forward to connecting with you soon. 152 00:05:21,110 --> 00:05:23,290 Thank you very much. Appreciate it. Thank you.